Novavax launch: What you should know about the new Corona vaccine

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Vaccinations start this week with the protein vaccine. The most important questions and answers.

It is vaccine number five against the new coronavirus: this week, the Covid vaccinations prepare Nuvaxovid of the U.S. company Novavax. 1.1 million doses have arrived in Austria so far – in a warehouse of one of the member companies of the Association of Pharmaceutical Wholesalers (Phago). Currently, delivery to the provinces is already in full swing. In total, the Ministry of Health has ordered 3.1 million doses for the first quarter of this year.

Several tens of thousands of people have already pre-registered for the protein vaccine. In Tyrol and Upper Austria, vaccinations started on Sunday; in Vienna, Styria, and Vorarlberg, vaccinations will start tomorrow, Tuesday. Lower Austria begins on Wednesday, Salzburg on Saturday.

What category of vaccine is Novavax exactly?

A recombinant (produced with the help of genetic modifications, note) protein vaccine. Nuvaxovid contains virus-like particles containing the coronavirus’s spike protein (surface protein). Non-dangerous viruses (baculoviruses) are genetically modified to include the genetic material for the spike protein. Insect cells (moth cells) are infected with these viruses and then produce the spike protein. This is taken from the cells, purified, and left is pure spike protein nanoparticles.

In the case of mRNA vaccines and vector vaccines, however, the production of the spike protein takes place in cells of the human body. Here, the vaccine only provides the genetic blueprint for the protein. Says clinical pharmacologist Markus Zeitlinger of MedUni Vienna: “So with previous vaccines, human cells have to produce the spike protein themselves; with a recombinant protein vaccine, insect cells do this in cell cultures. In vitro (i.e., in biotechnological production facilities outside the body, note).”

Are there advantages to this?

“In terms of safety and efficacy, Nuvaxovid is comparable to the other vaccines,” Zeitlinger says. The only “advantage in quotes,” he says, is that each person receives the same dose of spike protein (which the immune system recognizes as foreign and makes antibodies against). “I do know how much the insect cell made.” With mRNA vaccines, each person gets the same amount of genetic information (mRNA), “but of course, each person can then produce different amounts of the spike protein.”

How effective is the vaccine?

In a study in the U.S. and Mexico with a total of 30,000 participants, efficacy against symptomatic infections was 90.4 percent. Thus, vaccination prevents about 90 percent of covid-19 illnesses that would occur within three months without immunization. In the study, among 10,000 participants who received the actual vaccine, there were eight covid illnesses, compared with 77 covid diseases among 10,000 participants who received only a sham vaccine.

Does this vaccine also contain an efficacy booster?

Unlike the mRNA vaccines (Biontech/Pfizer, Moderna) and the vector vaccines (Astra Zeneca, Johnson & Johnson), Nuvaxovid also requires an effect enhancer (adjuvant) to produce a reliable immune response. The active enhancer used is called “Matrix-M.” “In addition to various fats and salts, it contains extracts from the bark of the soap bark tree,” according to the independent platform Medizin-transparent. At. Matrix-M is not yet contained in this particular composition in any other approved vaccine. However, further extracts from the soap bark tree are a vaccine against shingles (herpes zoster) or an additive for food certification.

Is this booster of concern?

No. “Saponin-based adjuvants have been used in a large number of vaccine development programs over the past 40 years,” says the European Medicines Agency (EMA) review report, for example.

But is this a classic vaccine?

No, says Zeitlinger. The term dead vaccine is used for vaccines with killed, inactivated whole pathogens. By that definition, only Valneva’s vaccine (not yet approved) is a dead vaccine. “All currently licensed Corona vaccines are neither dead nor live vaccines, but strictly speaking belong to other categories.”

How are the vaccines administered?

Two doses are injected about three weeks apart. For the time being, Novavax is only approved for primary immunization, which is why Vorarlberg, for example, has already announced that it will only use mRNA vaccines for the third vaccination.

Is Nuvaxovid suitable for boosting?

“From a scientific point of view, however, there is nothing to say against boosting with Nuvaxovid,” Zeitlinger says. The effect of a nuvaxovide booster is roughly comparable to a third mRNA vaccination, he says.

Boosting with Novavax is also an option for those who have had a severe reaction to an mRNA vaccination and therefore do not want an mRNA booster.

Should nuvaxovide be preferred to an mRNA vaccine now?

No. “It is comparable to the other vaccines. If Nuvaxovid and an mRNA vaccine were in front of me now, I would have no reason to advise one rather than the other. They are broadly comparable.”

However, the Biontech/Pfizer vaccine can also be stored at two °C to 8°C for a month after thawing.

“The protection against the omicron or delta variant of coronavirus has not been well studied,” the medical-transparent platform says. That’s because the original virus and the alpha variant circulated during the pivotal study. “However, this applies to the approval studies of all vaccines,” Zeitlinger emphasizes. In laboratory studies, the efficacy against delta and omicron was also basically comparable to that of the other vaccines.

When exactly will the vaccinations start?

Experts hope that Novavax will provide a new opportunity to convince those who previously opposed the vector and mRNA vaccines to vaccinate. According to the latest survey by the Austrian Corona Panel Project, just under one percent of the population is still “willing” to vaccinate, while just over four percent are “hesitant.”